Common Childhood Concerns

Guest Author - Gwenn Schurgin O'Keeffe, MD, FAAP

This past March I attended the American Baby Faire in Boston, MA, and had the opportunity to talk to hundreds of expectant parents, new parents and grandparents. Here's a collage of answers to many of the questions parents asked about that afternoon - as well as a few ideas you may not have thought about.

My 20 month old daughter keeps getting hives. Can she go to daycare?
Hives are very common and indicate an immune reaction to something. In some situations we can pinpoint them to a virus, food, bug bite, lotion, soap, jewelry, or medications but most times the actual cause eludes us. A child with hives associated with fever, trouble breathing, joint pain or swelling, fainting, looking ill, eating nuts or shellfish, or taking a medication, needs to be evaluated right away. Otherwise, the majority of hives will disappear as mysteriously as they arrived, and your child can attend daycare.

Is it true you can over bundle a baby?
It is true. Babies can get overheated very easily by being over swaddled or over-dressed. The best rule of thumb is to dress your baby as you dress yourself. Overheated babies can become fussy and clammy and may even run a low-grade temperature. That said, touch base with your pediatrician if your baby is fussy or has a rectal temperature 100.5 or higher just to be sure an illness is not occurring.

Should schools be nut free?
Many children are allergic to nuts and it is important for schools, camps and daycare centers to have a plan. Iíve seen some programs have nut free zones; others are completely nut free; and many require all treats to be prepackaged to monitor for nuts. If your childís school does not have a plan, they should.

What is normal preschool speech?
Speech is a complicated topic because there is such a wide range of normal. Talk to your public school speech department or pediatrician if you are concerned your child is not meeting these milestones, provided by The American Speech and Hearing Association (www.asha.org):

3-4 Years:
Talks about their day at school or at a friends house
Understandable by people outside the family
Uses 4 or more words in a sentence
Usually talks easily 4-5 Years:
Sounds like other kids
Uses a lot of detail in sentences
Can stick to a topic when talking
Talks easily with kids and adults
Can say most sounds well except: l, s, r, v, z, ch, sh, th.
Uses the same grammar as other family members

You can find more information at:
www.childdevelopmentinfo.com/development/language_development.shtml
www.pediatricsnow.com/salem_news_archive/jan_21_2003.html
www.asha.org/public/speech/development/child_hear_talk.htm

What can I do with 2 kids under 2?
Many things! More Than One, developed by Heather Kempskie, editor of Parents and Kids, and Lisa Hanson, Heatherís sister, tackles this very issue. Youíll find some excellent and creative suggestions at www.morethan1.net/.

What can I do for bedwetting in my older child?
This is such an important and complicated topic that Iíll be covering it in an upcoming column. In the meantime, talk to your childís pediatrician. There is a great deal you can do to help your child. Here is some web information that you may find helpful:
www.drgreene.com/21_586.html
www.kidshealth.org/parent/general/sleep/enuresis.html

Closing Thoughts
Our own experience is our best asset as a parent and one of the best gifts we can give each other is the benefit of that experience. At the Faire, a mother of two, ages 4 years and 9 weeks, shared with me this snapshot of her family:
Me: How is your older daughter adjusting to having a new baby at home?
Mom: Great! I give her jobs which helps us all out.
Me: Jobs? How does that work?
Mom: Well, I figured by making her part of the baby stuff sheíd feel more included. Her job is to get the diaper for every diaper change and help get the car seat ready. She loves this and it really helps us out! Besides, never too young to learn to have responsibilities.
What a brilliant idea! I wish I had thought of it when my kids were young. So often we have the older sibling be a bystander, mostly by need since there are few tasks young kids can actually help with early on with a baby. But, helping with the baby stuff and the logistics is something even very small children can understand and be successful at. Of course, being an experiences mom, this mom had motherís intuition that the other shoe will likely drop when her infant comes into her own and starts to get in her big sisterís way. Until then, sheís just enjoying the moment. Isnít that all any of us can do?

Have you found interesting ways to incorporate a new baby into the family? Do you have questions about common pediatric conditions? Fill out the comment box and let me know.